ABSTRACT Each year approximately 34,000 men and women participate in wildland fire suppression activities and prescribed burns. Shifts are long and often in rough terrain. Wildland firefighters (WFFs) routinely and repeatedly encounter exposures including particulate matter, carbon monoxide, nitrogen oxides, benzene, silica, and polycyclic aromatic hydrocarbons as well as noise, heat, physical exertion, emotional stress, and disrupted sleep. While studies have investigated the long-term impacts of structural firefighting, little work has explored long-term health in WFFs, a population of particular interest for the NIOSH Public Safety Sector Program's National Occupational Research Agenda (NORA). Aims: We will examine medical screening and employment data collected over 12 years to investigate cross-sectional and longitudinal relationships between occupational wildland firefighting exposure and markers of cardiovascular and respiratory health, and hearing assessed in Department of the Interior Medical Standards Program (DOI MSP) medical screening examinations between 2004 and 2011 and 2014 and 2016. We will emphasize specific, objective measures and biomarkers related to cardiovascular disease (CVD), a priority for the NIOSH Public Safety Sector, as well as hearing loss and pulmonary function in this population of WFFs. Sector and cross sector priorities: Our proposed work, leveraging existing data sources to identify health risks associated with wildland firefighting, is directly responsive to the strategic goals for wildland firefighting put forth in the NORA for the Public Safety Sector Program. Through our assessment of medical screening data and development of a methodology applicable to more extensive surveillance efforts, we will address Surveillance Cross-Sector program priorities. By increasing understanding of the contribution of wildland firefighting to CVD, we also will address an objective of the Cancer, Reproductive, and CVD Cross-Sector Program. Research to Practice: DOI MSP and US Forest Service partners have been closely involved in research needs identification and project design for this application. Continued collaboration with these partners as well as with NIOSH investigators will facilitate translation of findings for improved WFF screening and surveillance. Partners will participate in the dissemination of findings to stakeholders and the broader occupational health and safety community. Outcomes: We will create medical screening and occupational history databases on which screening and surveillance efforts can build and expand knowledge on specific health endpoints of importance in WFFs.